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Folic Acid Metabolism and Osteoporosis

Bisphosphonates are used in the treatment of low calcium states, such as Osteopenia/osteoporosis. Bisphosponates such as Fosamax, Boniva, Actonel are examples of this class of drugs. Years ago studies began to show that these drugs actually caused bisphosphonate osteonecrosis of the jaw. Osteonecrosis is a fancy word for cellular death of bone tissue. Studies have shown that this happens because these medications so commonly prescribed for women with low bone density, actually affect methylation in our DNA. 

Effects of bisphosphonate treatment on DNA methylation in osteonecrosis of the jaw.
Polidoro S, Broccoletti R, Campanella G, Di Gaetano C, Menegatti E, Scoletta M, Lerda E, Matullo G, Vineis P, Berardi D, Scully C, Arduino PG.
Mutat Res. 2013 Jul 24. pii: S1383-5718(13)00203-9. doi: 10.1016/j.mrgentox.2013.07.003. [Epub ahead of print]

Methylation is an important chemical process that occurs in the body. It is an important process in detoxification, protein function, DNA expression, blood clotting, and more. A simple truth is that folic acid is involved in this process and not just any folic acid, but the active form of folic acid called 5tetrahydrofolate folic acid. In otherwords, in order for folic acid to function effectively in the body, it must be ‘activated’. 

The body takes folic acid and “activates” it with a special enzyme that is made by the body based on instructions that are dependant upon specific genes. These genes that hold the instructions to activate folic acid are called MTHFR. It is suggested that up to 40% of the population has some variant genetic disorder on the MTHFR gene. 

Folic acid is involved in many enzyme pathways. It is important in blood clot formation and regulation, regulating normal cell growth, making the ‘happy’ chemicals in your brain, helping to make red and white blood cells, and more. As you can see, it is also an important part of bone remodeling. 

A recent study showed that post menopausal women who had an MTHFR mutation had an increased risk of ostoporosis. 
Association of MTHFR C677T polymorphism with bone mineral density of osteoporosis in postmenopausal Thai women. J Med Assoc Thai. 2013 Feb;96(2):133-9.
At NatureMed, we test for MTHFR polymorphisms on our routine blood work. We have discovered that women who have a genetic history of strokes and mood disorders in the family, and/or a personal history of abnormal pap tests, also have a higher incidence of this gene mutation. 

You may wonder, ‘why check for this mutation?’. Well, if you are not activating folic acid (no matter how healthy your diet is or how many supplements you take) then you may be at an increased risk for some of these conditions. If you are not activating folic acid it is important to know this so that you can then invest in a form of folic acid supplementation that is already ‘activated’ as well as preventing diseases that are associated with folic acid deficiency. These products are very popular now due to the increased awareness and diagnosis of those with the MTHFR polymorphisms. Depending upon the outcomes of the genetic testing combined with health history, our dosing can vary from 1,000mcg and up to 10,000mcg daily.